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HomeMy WebLinkAbout1125 COFFEE RD 2008 FMC RESULTS MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited:Chapter 6.7,Health and Safety Code;Chapter 16,Division 3 Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility,a separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system ownerloperator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A.General Information Facility Name: CHEVRON 203576 City: BAKERSFIELD CA Zip:93308 Site Address: 1125 COFFEE RD. Contact Phone No: 588-9066 Date of Testing/Service: 11/17/2008 Facility Contact Person: MANAGER Make/Model of Monitoring System:TLS-350 Work Order Number: 3163334 I IIIIIII VIII III IIII 63 B.Inventory of Equipment Tested/Certified IE Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: 1-91 Tank ID: 2-89 X In-Tank Gauging Probe. Model: MAG X In-Tank Gauging Probe. Model: MAG X Annular Space or Vault Sensor. Model: VR-420 Annular Space or Vault Sensor. Model: VR-420 X Piping Sump/Trench Sensor(s). Model: VR-208 Piping Sumpi7rench Sensor(s). Model: VR-208 Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: D Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: EPLLD X Electronic Line Leak Detector. Model: EPLLD X Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER Tank OverfilUHigh-Level Sensor. Model: ATG/FLAPPER Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2). Tank ID: Tank ID: In-Tank Gauging Probe. Model: MAG In-Tank Gauging Probe, Model: X Annular Space or Vault Sensor. Model: VR-420 Annular Space or Vault Sensor. Model: X Piping Sump/Trench Sensor(s). Model: VR-208 Piping SumplTrench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: EPLLD Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER Tank Overfill/High-Level Sensor. Model: Other(specify equipment type and model in Section E on page 2). Other(specify equipment type and model in Section E on page 2). ispenser : 1 Dispenser ID: 2 ®Dispenser Containment Sensor(s) Model: BEI 406 X Dispenser Containment Sensor(s) Model: BEI-406 RI Shear Valve(s). X Shear Valve(s) 0 Dispenser Containment Float(s)and Chain(s). 7 Dispenser Containment Float(s)and Chain(s). Dispenser ID: 3 Dispenser ID: 4 X❑Dispenser Containment Sensor(s) Model:BEI-406 X Dispenser Containment Sensor(s). Model:BEI-406 x❑ Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s). Dispenser ID: 5 Dispenser ID: 6 X❑ Dispenser Containment Sensor(s) Model: BEI-406 X Dispenser Containment Sensor(s). Model:BEI-406 0 Shear Valve(s). X Shear Valve(s). Dispenser Containment Float(s)and Chain(s). Dispenser Containment Float(s)and Chain(s). If the facility contains more tanks or dispensers,copy this form.Include information for every tank and dispenser at the facility. C. Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers'guidelines. Attached to this certification is information(e.g manufacturers'checklists)necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports,I have also attached a copy of the(Check all that apply): System set-up X❑Alarm history report T ec hnician Name(print): AXEL MEDINA Signature: Certification No.: B-36644 License.No.: 743160(Class'A'General Enginering Contractor License) Testing Company Name:Tanknology Phone No.: (800)800-4633 Site Address: 8501 N.MoPac Expressway,suite 400,Austin,TX 78759 Date of Testing/Servicing: 11/17/2008 Monitoring System Certification Page 1 of 3 I IIIIIII VIII III IIII 64 Based on CA form dated 03/01 IE Monitoring System Certification Site Address 1125 COFFEE RD. Date of Testing/Service: 11/17/2008 D. Results of Testing/Servicing Software Version Installed: 327.04 Complete the following checklist: E Yes No' Is the audible alarm operational? Q Yes No* Is the visual alarm operational? ❑x Yes No' Were all sensors visually inspected,functionally tested,and confirmed operational? Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not Q Yes ❑No• interfere with their proper operation? x Yes No' N/A If alarms are relayed to a remote monitoring station,is all communications equipment(e.g.modem)operational? For pressurized piping systems,does the turbine automatically shut down if the piping secondary containment Yes ❑No' 1:1 N/A monitoring system detects a leak,fails to operate,or is electrically disconnected?If yes:which sensors initiate positive shut-down?(check all that apply) 0 Sump/Trench Sensors; 0 Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 0 Yes No M Yes ❑No. N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device(i.e.:no mechanical overfill prevention valve is installed),is the overfill warning alarm visible and audible at the tank fill points(s)and operating properly? If so,at what percent of tank capacity does the alarm trigger? 2 Yes- No Was any monitoring equipment replaced?If yes,identify specific sensors,probes,or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E,below. 0 Yes* ❑No Was liquid found inside any secondary containment systems designed as dry systems?(check all that apply) x❑Product; ❑X Water. If yes,describe causes in Section E,below. Q x Yes ❑No• Was monitoring system set-up reviewed to ensure proper settings?Attach set-up reports,if applicable. 0 Yes ❑No• Is all monitoring equipment operational per manufacturers'specifications? "In Section E below,describe how and when these deficiences were or will be corrected. E. Comments: Page 2 of 3 Based on CA form dated 03/01 Monitoring System Certification Site Address: 1125 COFFEE RD. Date of Testing/Service: 11/17/2008 F. In-Tank Gauging / SIR Equipment ❑ Check this box if tank gauging is used only for inventory control. ❑ Check this box if no tank gauging or SIR equipment is installed. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: 0 Yes ❑No Has all input wiring been inspected for proper entry and termination,including testing for ground faults? ❑Yes ❑No• Were all tank gauging probes visually inspected for damage and residue buildup? OYes ❑No* Was accuracy of system product level readings tested? ❑Yes ❑No. Was accuracy of system.water level readings tested? X Yes ❑No' Were all probes reinstalled properly? 0 Yes [:]No* Were all items on the equipment manufacturers'maintenance checklist completed? 'In the Section H,below,describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) : ❑ Check this box if LLDs are not installed. Complete the following checklist: For equipment start-up or annual equipment certification,was a leak simulated to verify LLD performance? 0 Yes [:]No* ❑NIA (Check all that apply)Simulated leak rate: x❑ 3 g.p.h❑0.1 g.p.h ❑0.2 g.p.h M Yes ❑No* Were all LLDs confirmed operational and accurate within regulatory requirements? x Yes ❑No• Was the testing apparatus properly calibrated? ❑Yes ❑No' ❑x N/A For mechanical LLDs,does the LLD restrict product flow if it detects a leak? 0 Yes ❑No• ❑N/A For electronic LLDs,does the turbine automatically shut off if the LLD detects a leak? ❑Yes ❑No* ❑NIA For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? 0 Yes ❑No• ❑N/A For electronic LLDs,does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Yes No* ❑NIA For electronic LLDs,have all accessible wiring connections been visually inspected? Yes ❑No" Were all items on the equipment manufacturers'maintenance checklist completed? 'In the Section H,below,describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 Based on CA form dated 03/01 $WRCB,January 2002 Page 1. Secondary Containment Testing Report Form I/- This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and O printouts from tests(f applicable),should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CHEVRON 203576 Date of Testing: 11/17/2008 Facility Address: 1125 COFFEE RD. BAKERSFIELD, CA, 93308 Facility Contact: MANAGER Phone: (6 61) 588-9066 Date Local.Agency Was Notified of Testing Name of Local Agency Inspector(if present during testing): ERNIE MEDINA BFFD 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: AXEL MEDINA Credentials: CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type: License Number: Manufacturer Training Manufacturer Component(s) Date Training Expires 3. SUMMARY OF TEST RESULTS Not Repairs Not Repair Component Pass Fail Tested Made Component Pass Fail Tested Made Spill Box 1 SUP FILL E 0 0 0 0 0 0 0 Spill Box 2 PLU FILL El 0 0 0 0 0 0 ❑ Spill Box 3 REG FILL E ❑ ❑ ❑ ❑ ❑ ❑ ❑ 0 0 0 El 0 0 El 1:1 0 0 0 0 0 0 0 0 0 0 0 Eli Eli I 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 If hydrostatic testing was performed,describe what was done with the water after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician's Signature: ,d Date: 11/17/2008 SWRCB,January 2006 9. Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form and printouts from tests(if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CHEVRON 203576 Date of Testing: 11/17/2008 Facility Address: 1125 COFFEE RD. , BAKERSFIELD, CA, 93308 Facility Contact: MANAGER Phone: (6 61) 588-9066 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector(if present during testing): ERNIE MEDINA BFFD 2. TESTING CONTRACTOR INFORMATION Company Name: TANKNOLOGY, INC. Technician Conducting Test: AXEL MEDINA Credentials 1: ❑CSLB Contractor [�]ICC Service Tech. ❑SWRCB Tank Tester ❑Other(Specify) License Number: 3. SPILL BUCKET TESTING INFORMATION Test Method Used: Hydrostatic ❑ Vacuum ❑ Other Test Equipment Used:VISUAL Equipment Resolution: Identify Spill Bucket(By Tank 1 1 SUP FILL 2 2 PLU FILL 3 3 REG FILL 4 Number, Stored Product, etc) X❑Direct Bury X❑ Direct Bury X❑Direct Bury ❑Direct Bury Bucket Installation Type: ❑Contained in Sump ❑ Contained in Sump ❑Contained in Sump ❑Contained in Sump Bucket Diameter: 12 12 12 Bucket Depth: 13 13 13 Wait time between applying 0 0 0 vacuum/water and starting test: Test Start Time(TI ): 1025 1025 1025 Initial Reading(Rl ): 10 10 10 Test End Time(TF ): 1125 1125 1125 Final Reading(RF ): 10 10 10 Test Duration: 1 HR 1 HR 1 HR Change in Reading(R F-R1 ): 0 0 0 Pass/Fail Threshold or 0 0 0 Criteria: Ties_ W.-1: ass ® Fail 001 Fail ass ® ail_ ail COinments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate,and in full compliance with legal requirements. Technician's Signature: ,� Date: 11/17/2008 1 State laws and regulations do not currently require testing to be performed by a qualified contractor.However,local requirements 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE:11/17/08 WORK ORDER NUMBER3163334 CLIENT:CHEVRON PRODUCTS COMPANY SITE:CHEVRON 203576 COMMENTS Conducting Annual monitor certification with Carol from Bakersfield fire. Replaced (1) Fe Petro Siphon jet valve, (2) OPW 3/8 test port plug. (1) Hour labor for parts replacement and troubleshooting. All tests pass. PARTS REPLACED QUANTITY ����Q[S-ORIR�" IO N - 1 SYPHON CHECK VALVE 2 3/8" TEST PORT PLUG WITH WIRE SEAL HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITE S TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 11/21/2008 08:22 ACRAMER SITE DIAGRAM p 7anknology 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 (512)451-6334 FAX(512)459-1459 TEST DATE:11/17/08 WORK ORDER NUMBER3 16 3 3 3 4 CLIENT:CHEVRON PRODUCTS COMPANY SITE: CHEVRON 203576 C3 > L STP L2 89 OA OI OV OF #3 #4 # #6 #11 12 cn (Z 12K zm C/) C L3 87 L6 CANOPY Z � e 12KO O O O D cZ 0 z #1 #2 #7 #8 #9 10 n p L4 91 L5 cA STP rn 12K OI O OF s FE-S-0] DUMP- . STER C-STORE AIR/ breakers TLS H2O ICE CAR WASH Printed 11/21/2008 08:22 ACRAMER 69LSL scxa,L`uttsnV`OOt7 altnS `Xumssaidxg oEdoW-M LOSS "oul A2olou3lusZ (M)&(ESV)Testing Fonn-Vasioo 1-6252007 Emergency Shut Off(ESO) & Dispenser Emergency Shutoff Valve (ESV) ANNUAL TEST RECORD LOCATIONS AND TEST DATA Testing I/—/�-�—n /�C / Date: Locaton Name: CkY ,v xl � S?4 Store#: 035 Statc m#: Address: IQ Co ffi e—Q_J_ City: k� ;Q State: G Emergency Shut Off(ESO) Testing Results On//-1?-o d in accordance with"ESO Vendor Ixetter(3-21-05).doc",from Valero's Retail Compliance Department,as a part of annual compliance testing,this representative tested the Emergency Shut Off SO switches indicated on this sketch.Findings listed below: Emergency Shut Off(ESO) If No,Provide Operational? Y N Maintenance Log# Date Called Dispenser Emergency Shutoff Valve (ESV) Testing Results On I I-/?-o'd in.accordance with NFPA 30A this representative tested the automatic-closing feature of the Dispenser Emergency Shutoff VALVE(S)(ESV)located in the supply lines at the base of each individual island type dispenser indicated on the diagram below.Each device( in all, would automatically close.Findings listed below: Disp.Emergency Shut Off If No,Provide Valve(ESV)Operational? N Maintenance Log# Date Called: Site Map Of Location and Placement of Devices Testcd: d 0 pp O O 00 6) o Signature Of Representative: b£££9T£ :JOPiO110M ATG Information Work Order# 3163334 120100 NOV 17,2008 3:00 PM C.S.I.CHEVRON 1842 1125 COFFEE RD. B AK E RS F I E L D,CA.93312 661-588-9066 203576 IN-TANK INVENTORY TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP 1 SUPREME 3160 3128 8908 34.36 0.76 74.27 2 PLUS 1382 1367 10686 19.17 0.00 75.27 3 REGULAR 1831 1816 10237 23.31 0.00 71.02 130100 NOV 17,2008 3:00 PM C.S.I.CHEVRON 1842 1125 COFFEE RD. BAK E RS F I E L D,CA.93312 661-588-9066 203576 LIQUID STATUS REPORT SENSOR LOCATION STATUS 1 SUPREME TURBINE SUMP SENSOR NORMAL 2 SUPREME ANNULAR SENSOR NORMAL 3 REG TURBINE SUMP SENSOR NORMAL 4 PLUS ANNULAR SENSOR NORMAL 5 PLUS TURBINE SUMP SENSOR NORMAL 6 REGULARANNULAR SENSOR NORMAL 137300 NOV 17,2008 3:00 PM C.S.I.CHEVRON 1842 1125 COFFEE RD. BAKERSF I ELD,CA.93312 661-588-9066 203576 PRESSURE LINE LEAK TEST RESULTS Q 1:SUPREME 3.0 GAUHR RESULTS: LAST TEST: NOV 17,2008 2:48 PM PASS NUMBER OF TESTS PASSED PREV 24 HOURS: 49 SINCE MIDNIGHT: 25 0.10 GAL/HR RESULTS: NO 0.10 DATA AVAILABLE 0.20 GAL/HR RESULTS: NO 0.20 DATA AVAILABLE NO-VENT TEST ABORTS: 0 OUT OF 0 TEST Q 2:PLUS 3.0 GAUHR RESULTS: 3163334 ATG Information Work Order# 3163334 LAST TEST: NOV 17,2008 2:46 PM PASS NUMBER OF TESTS PASSED PREV 24 HOURS: 41 SINCE MIDNIGHT: 23 0.10 GAUHR RESULTS: NO 0.10 DATA AVAILABLE 0.20 GAUHR RESULTS: NO 0.20 DATA AVAILABLE NO-VENT TEST ABORTS: 0 OUT OF 0 TEST Q 3:REGULAR 3.0 GAUHR RESULTS: LAST TEST: NOV 17,2008 2:59 PM PASS NUMBER OF TESTS PASSED PREV 24 HOURS: 121 SINCE MIDNIGHT: 66 0.10 GAUHR RESULTS: NO 0.10 DATA AVAILABLE 0.20 GAUHR RESULTS: NO 0.20 DATA AVAILABLE NO-VENT TEST ABORTS: 0 OUT OF 0 TEST 150301 NOV 17,2008 3:00 PM #1:C.S.I.CHEVRON 1842 150302 NOV 17,2008 3:00 PM #2:1125 COFFEE RD. 150303 NOV 17,2008 3:00 PM #3:BAKERSFIELD,CA.93312 150304 NOV 17,2008 3:00 PM #4:661-588-9066 203576 151700 3163334 ATG Information Work Order# 3163334 NOV 17,2008 3:00 PM SYSTEM TYPE AND LANGUAGE FLAG SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM 150F00 NOV 17,2008 3:00 PM MON DD YYYY HH:MM:SS xM 110200 NOV 17,2008 3:00 PM C.S.LCHEVRON 1842 1125 COFFEE RD. BAKERSF I ELD,CA.93312 661-588-9066 203576 SYSTEM CONFIGURATION SLOT BOARD TYPE POWER ON RESET CURRENT 1 UNUSED 9806874 9598638 2 UNUSED 9707198 9574649 3 7SMARTSENSOR BD 507094 506332 4 PLLD SENSOR BD 3948 3942 5 INTERSTITIAL BD 201845 201634 6 4 PROBE/G.T. 162885 162869 7 UNUSED 9705354 9572434 8 UNUSED 9686467 9570873 9 UNUSED 9685294 9565987 10 PLLD POWER BD 100582 100614 11 UNUSED 9688028 9573498 12 UNUSED 9691072 9565228 13 UNUSED 9675747 9567316 14 UNUSED 9690761 9562949 15 UNUSED 9674255 9568202 16 UNUSED 9689726 9573034 COMM 1 RS232 SERIAL BD 14910 14901 COMM 2 FAXMODEM BOARD 40091 40430 COMM 3 ELEC DISP INT. 101111 101174 COMM 4 UNUSED 9686888 9577296 COMM 5 R9485 SERIAL BD 68615 6B683 COMM 6 RS232 SERIAL BD 14910 14943 170300 NOV 17,2008 3:01 PM LIQUID TYPE SENSOR LOCATION TYPE 1 SUPREME TURBINE SUMP TRI-STATE(SINGLE FLOAT) 2 SUPREME ANNULAR TRI-STATE(SINGLE FLOAT) 3 REG TURBINE SUMP TRI-STATE(SINGLE FLOAT) 4 PLUS ANNULAR TRI-STATE(SINGLE FLOAT) 5 PLUS TURBINE SUMP TRI-STATE(SINGLE FLOAT) 6 REGULAR ANNULAR TRI-STATE(SINGLE FLOAT) 7 TRI-STATE(SINGLE FLOAT) 8 TRI-STATE(SINGLE FLOAT) 160100 NOV 17,2008 3:01 PM 3163334 ATG Information Work Order# . 3163334 TANK CONFIGURATION DEVICE LABEL CONFIGURED 1 SUPREME ON 2 PLUS ON 3 REGULAR ON 4 OFF 160200 NOV 17,2008 3:01 PM TANK PRODUCT LABEL TANK PRODUCT LABEL 1 SUPREME 2 PLUS 3 REGULAR 4 160300 NOV 17,2008 3:01 PM TANK PRODUCT CODE TANK PRODUCT LABEL 1 SUPREME 1 2 PLUS 2 3 REGULAR 3 4 4 160400 NOV 17,2008 3:01 PM TANK FULL VOLUME TANK PRODUCT LABEL GALLONS 1 SUPREME 12068 2 PLUS 12068 3 REGULAR 12068 4 0 160700 NOV 17,2008 3:01 PM TANK DIAMETER TANK PRODUCT LABEL INCHES 1 SUPREME 111.50 2 PLUS 111.50 3 REGULAR 111.50 4 0.00 160900 NOV 17,2008 3:01 PM TANK THERMAL COEFFICIENT TANK PRODUCT LABEL 1 SUPREME 0.000700 2 PLUS 0.000700 3 REGULAR 0.000700 4 0.000000 161200 NOV 17,2008 3:01 PM TANK MANIFOLDED PARTNERS TANK PRODUCT LABEL SIPHON MANIFOLDED TANKS LINE MANIFOLDED TANKS 3163334 ATG Information Work Order# 3163334 1 SUPREME NONE NONE 2 PLUS NONE NONE 3 REGULAR NONE NONE 4 NONE NONE 162100 NOV 17,2008 3:01 PM TANK LOW PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 500 2 PLUS S00 3 REGULAR 500 4 0 162200 NOV 17,2008 3:01 PM TANK HIGH PRODUCT LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 11464 2 PLUS 11464 . 3 REGULAR 11464 4 0 Ll 162300 NOV 17,2008 3:01 PM TANK OVERFILL LEVEL LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 10861 2 PLUS 10861 3 'REGULAR 10861 4 0 162400 NOV 17,2008 3:01 PM TANK HIGH WATER LEVEL LIMIT TANK PRODUCT LABEL INCHES 1 SUPREME 3.0 2 PLUS 3.0 3 REGULAR 3.0 162800 NOV 17,2008 3:01 PM TANK MAXIMUM VOLUME LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 12068 2 PLUS 12068 3 REGULAR 12068 4 0 162900 NOV 17,2008 3:01 PM TANK DELIVERY REQUIRED LIMIT TANK PRODUCT LABEL GALLONS 1 SUPREME 1209 2 PLUS 1209 3 REGULAR 1209 4 0 3163334 ATG Information Work Order# 3163334 170300 NOV 17,2008 3:01 PM LIQUID TYPE SENSOR LOCATION TYPE 1 SUPREME TURBINE SUMP TRI-STATE(SINGLE FLOAT) 2 SUPREME ANNULAR TRI-STATE(SINGLE FLOAT) 3 REG TURBINE SUMP TRI-STATE(SINGLE FLOAT) 4 PLUS ANNULAR TRI-STATE(SINGLE FLOAT) 5 PLUS TURBINE SUMP TRI-STATE(SINGLE FLOAT) 6 REGULAR ANNULAR TRI-STATE(SINGLE FLOAT) 7 TRI-STATE(SINGLE FLOAT) 8 TRI-STATE(SINGLE FLOAT) 178500 NOV 17,2008 3:01 PM PRESSURE LINE LEAK TANK NUMBER LINE TANK NUMBER Q 1:SUPREME 1 Q 2:PLUS NONE 0 3:REGULAR 3 190200 NOV 17,2008 3:01 PM SOFTWARE REVISION LEVEL VERSION 327.04 SOFTWARE#346327-100-E CREATED-07.02.06.10.28 S-MODULE#330160.004-a SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS ISD PMC 120600 NOV 17,2008 3:02 PM C.S.I.CHEVRON 1842 1125 COFFEE RD. BAKERSF IELD,CA.93312 661-588-9066 203576 TANK ALARM HISTORY TANK 1 SUPREME HIGH WATER ALARM NOV 17,2008 11:00 AM OVERFILL ALARM NOV 17,2006 10:45 AM JUL 24,2008 8:43 AM SUDDEN LOSS ALARM NOV 17,2008 11:03 AM NOV 17,2008 10:40 AM HIGH PRODUCT ALARM NOV 17,2008 10:56 AM JUL 24,2008 8:43 AM FEB 6,2007 8:05 AM INVALID FUEL LEVEL NOV 17,2008 11:04 AM SEP 19,2008 6:35 PM PROBE OUT NOV 17,2008 1:25 PM NOV 17,2008 10:40 AM SEP 19,2008 8:29 AM HIGH WATER WARNING NOV 17,2008 11:00 AM DELIVERY NEEDED NOV 17,2008 11:03 AM OCT 24,2008 12:00 PM 3163334 ATG Information Work Order# 3163334 OCT 3,2008 1:26 PM MAX PRODUCT ALARM NOV 17,2008 10:56 AM LOW TEMP WARNING JUL 24,2008 8:45 AM TANK 2 PLUS HIGH WATER ALARM NOV 17,2008 11:09 AM OVERFILL ALARM NOV 17,2008 10:50 AM JUL 24,2008 8:55 AM HIGH PRODUCT ALARM NOV 17,2008 10:56 AM INVALID FUEL LEVEL NOV 17,2008 11:07 AM JUL 24,2008 8:54 AM PROBE OUT NOV 17,2008 121 PM NOV 17,2008 10:42 AM JUL 24,2008 8:56 AM HIGH WATER WARNING NOV 17,2008 11:09 AM DELIVERY NEEDED NOV 17,2008 11:07 AM NOV 17,2008 10:42 AM NOV 12,2008 7:11 PM MAX PRODUCT ALARM NOV 17,2008 11:00 AM LOW TEMP WARNING JUL 24,2D08 8:57 AM TANK REGULAR _ HIGH WATER ALARM NOV 17,2008 10:47 AM OVERFILL ALARM NOV 17,200811:10 AM NOV 17,2008 10:50 AM JUL 24,2008 8:46 AM SUDDEN LOSS ALARM NOV 17,2008 11:03 AM NOV 17,2008 10:41 AM HIGH PRODUCT ALARM NOV 17,200810:50 AM JUL 24,2008 8:45 AM INVALID FUEL LEVEL NOV 17,2008 11:04 AM NOV 12,2008 3:14 PM OCT 24,2008 4:24 PM PROBE OUT NOV 17,2008 1:22 PM NOV 17,2008 10:41 AM JUL 24,2008 6:50 AM HIGH WATER WARNING NOV 17,2008 10:46 AM DELIVERY NEEDED NOV 17,2008 11:04 AM NOV 17,2008 10:41 AM NOV 15,2008 8:54 PM MAX PRODUCT ALARM NOV 17,2008 10:56 AM IB0100 NOV 17,2008 3:02 PM LIQUID DIAGNOSTIC REPORT SAMPLE HIGH LOW SENSOR COUNTER REF REF VALUE 1 5 1010 167 101192 2 5 1010 167 95765 3 5 1010 167 101462 4 5 1010 167 98691 5 5 1008 167 99297 6 5 1008 167 102612 7 5 1008 167 999999680 8 5 1008 167 999999680 130200 NOV 17,2008 3:02 PM 3163334 ATG Information Work Order# 3163334 C.S.I.CHEVRON 1842 1125 COFFEE RD. BAKERSF IELD,CA.93312 661-588-9066 203576 LIQUID ALARM HISTORY REPORT SENSOR LOCATION 1 SUPREME TURBINE SUMP NOV 17,2008 11:15 AM SENSOR OUT ALARM NOV 17,2008 10:31 AM FUEL ALARM JUL 24,2008 8:40 AM SENSOR OUT ALARM 2 SUPREME ANNULAR NOV 17,2008 11:16 AM FUEL ALARM NOV 17,200811:15 AM SENSOR OUT ALARM NOV 17,2008 10:32 AM FUEL ALARM 3 REG TURBINE SUMP NOV 17,2008 11:15 AM SENSOR OUT ALARM NOV 17,2008 10:29 AM FUEL ALARM JUL 24,2008 8:40 AM SENSOR OUT ALARM 4 PLUS ANNULAR NOV 17,2008 11:15 AM SENSOR OUT ALARM NOV 17,2008 10:28 AM FUEL ALARM JUL 24,2008 8:33 AM FUEL ALARM 5 PLUS TURBINE SUMP NOV 17,2008 1:26 PM FUEL ALARM NOV 17,2008 11:15 AM SENSOR OUT ALARM NOV 17,2008 10:27 AM FUEL ALARM 6 REGULAR ANNULAR NOV 17,2008 11:15 AM SENSOR OUT ALARM NOV 17,2008 10:43 AM FUEL ALARM NOV 17,2008 10:43 AM SENSOR OUT ALARM 138200 NOV 17,2008 3:02 PM C.S.I.CHEVRON 1842 1125 COFFEE RD. BAKERSF IELD,CA.93312 661-588-9066 203576 PRESSURE LINE LEAK ALARM HISTORY REPORT Q 1:SUPREME NOV 17,2008 1223 PM PLLD SHUTDOWN ALARM NOV 17,2008 12:23 PM GROSS LINE FAIL NOV 17,2008 10:32 AM PLLD SHUTDOWN ALARM NOV 17,2008 10:31 AM PLLD SHUTDOWN ALARM JUL 28,2008 7:41 AM PLLD SHUTDOWN ALARM JUL 24,2008 9:51 AM PLLD SHUTDOWN ALARM JUL 24,2008 9:51 AM GROSS LINE FAIL JUL 24,2008 8:32 AM PLLD SHUTDOWN ALARM Q 2:PLUS NOV 17,2008 1:26 PM PLLD SHUTDOWN ALARM NOV 17,2008 12:05 PM PLLD SHUTDOWN ALARM NOV 17,2008 12:05 PM GROSS LINE FAIL NOV 17,2008 11:15 AM PLLD SHUTDOWN ALARM NOV 17,2008 11:09 AM PLLD SHUTDOWN ALARM NOV 17,2008 1028 AM PLLD SHUTDOWN ALARM NOV 17,2008 10:27 AM PLLD SHUTDOWN ALARM JUL 24,2008 9:47 AM PLLD SHUTDOWN ALARM JUL 24,2008 9:47 AM GROSS LINE FAIL JUL 24,2008 8:33 AM PLLD SHUTDOWN ALARM Q 3:REGULAR NOV 17,2008 1:06 PM PLLD SHUTDOWN ALARM NOV 17,2008 1:06 PM GROSS LINE FAIL NOV 17,2008 11:15 AM PLLD SHUTDOWN ALARM NOV 17,2008 10:43 AM PLLD SHUTDOWN ALARM NOV 17,2008 10:41 AM PLLD SHUTDOWN ALARM NOV 17,2008 10:40 AM PLLD SHUTDOWN ALARM NOV 17,2008 10:30 AM PLLD SHUTDOWN ALARM NOV 17,2008 10:29 AM PLLD SHUTDOWN ALARM OCT 3,2008 222 PM FUEL OUT 3163334 ATG Information Work Order# 3163334 AUG 5,2008 5:49 PM FUEL OUT 3163334 _ h r Tanknology caw fx*$ �s 8501 N. MoPac Expressway, Suite 400 Austin,Texas 78759 5 Pi/f U��C&TS 2% v"' Phone: (512)451-6334 p,Q;g���✓2� TSB Fax: (512)459-1459 Date Printed and Mailed: 11/21/2008 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1501 TRUXTUN AVE. BAKERSFIELD, CA. 93301 Test Date: 11/17/2008 Order Number: 3163334 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing performed: Leak detector tests Monitor Certification Secondary Containment-Spill Container Sincerely, Dawn Kohlmeyer �o Manager, Field Reporting O 0 Ric' 17�070>f0 TANKNOLOGY CERTIFICATE OF TESTING 9y 8501 N MOPAC EXPRESSWAY,SUITE 400 AUSTIN,TEXAS 78759 TELEPHONE(512)451-6334 FAX(512)459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 11/17108 WORK ORDER NUMBER: 3163334 CUSTOMER PO: 4691359 CLIENT: CHEVRON PRODUCTS COMPANY SITE:CHEVRON 203576 145 S.STATE COLLEGE BLVD 1125 COFFEE RD. SUITE 400 BAKERSFIELD,CA 93308 BREA,CA 92821 TINA SCOLARO MANAGER (714)671-3356 (661)588-9066 Product Pipe Ti htness Test Results LINE LINE L E DELIVERY IfiAP`/iCT ID PRODUCT MATERIAL E TEST RESULT FINAL L RATE (gph) VALVE A B C D A B C D FU.NC-�11Q. 12k 1 SUPREME DW FIBERG PRESSURE Y 12k 2 PLUS DW FIBERG PRESSURE Y 12k 3 REGULAR DW FIBERG PRESSURE Y Existing Line Leak Detector Test ® EXI$TINGjLEAK DES1TE�C OR#1, ®�I EXI$;11NGjllE'AK DEgTLEC O #2 LINE MAN FACTURER MODEL# ERIAL# RESULT MANUFACTURER MODEL# SERIAL# RESULT ID 12k 1 VEEDERROOT ELECTRONI 011505 P 12k 2 VEEDERROOT ELECTRONI 013652 P 12k 3 VEEDERROOT ELECTRONI 013649 P New Replacement Line Leak Detector Test LINE MANUFACTURER FMODEL# SERIAL# RES LT MANUFACTURER MODEL SERIAL# RESUL ID For owner detailed report information,visit www.tanknology.com and select On-Line Reports-WRAP,or contact your local Tanknology office. Tester Name:AXEL MEDINA Technician Certification Number: Printed 11/21/2008 08:22 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS i T"rnldW*39y 8501 N MOPAC EXPRESSWAY,SUITE 400 TEST DATE: 11/17/08 AUSTIN,TEXAS 78759(512)451-6334 WORK ORDER NUMBER: 3163334 CLIENT: CHEVRON PRODUCTS SITE: CHEVRON 203576 TAN IIJFaORI{AATIQN- Tank ID: 12k 1 Tank manifolded: No Bottom to top fill in inches: 165.0 Product: SUPREME Vent manifolded: YES Bottom to grade in inches: 170.0 Capacity in gallons: 12,068 Vapor recovery manifolded: YES Fill pipe length in inches: 54.0 Diameter in inches: 111.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RESULTS t M th�d: LEAK DETECTOR TEST RESULTS Test method: Tes e o PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D.#1 L.D.#1 L.D.#2 L.D.#2 UFT/OFT: Make: VEEDERROOT Fluid volume in gallons: Model: ELECTRONIC Tank water level in inches: S/N: 011505 Test time: NOT Open time in sec: Number of thermisters: TESTED Holding psi: NOT Specific gravity: Resiliency cc: TESTED Water table depth in inches: Test leak rate ml/m: 189.0 Determined by(method): Metering psi: Leak rate in gph: Calib. leak in gph: 3.00 Result: Results: PASS COMMENTS COMMENTS ULLAGE TES° RESULTrSTest Metho LINE TEST RESULTS Test type Test time: Material: DW FIBERG Ullage volume: Diameter(in): 2.0 Ullage pressure: Length (ft): 225.0 Results: Test psi: Bleedback cc: DATA FOR UTS-4T ONLY: Test time(min): Test 1:Start time: Time of test 1: Finish psi: NOT NOT NOT NOT Temperature: NOT Vol change cc: Test 2:Start time: TESTED TESTED TESTED TESTED Flow rate(cfh): TESTED Finish psi: Time of test 2: Vol change cc: Test 3:Start time: Temperature: Finish psi: Flow rate(cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate(cfh): Pump type: PRESSURE COMMENTS Pump make: FE PETRO COMMENTS Impact Valves Operational: YES Printed 11/21/2008 08:22 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS .Targa ology 8501 N MOPAC EXPRESSWAY,SUITE 400 TEST DATE: 11/17/08 AUSTIN,TEXAS 78759(512)451-6334 WORK ORDER NUMBER: 3163334 CLIENT: CHEVRON PRODUCTS SITE: CHEVRON 203576 TANKj1NFi0RMA,TI Tank ID: 12k 2 Tank manifolded: NO Bottom to top fill in inches: 166.0 Product: PLUS Vent manifolded: YES Bottom to grade in inches: 171.0 Capacity in gallons: 12,068 Vapor recovery manifolded: YES Fill pipe length in inches: 55.0 Diameter in inches: 111.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage 11 vapor recovery: ASSIST CP installed on: COMMENTS TANK TES RESULTS Te ethod: L DETE OR TES OEM ethod PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D.#1 L.D.#1 L.D.#2 L.D.#2 LIFT/OFT: Make: VEEDERROOT Fluid volume in gallons: Model: ELECTRONIC Tank water level in inches: S/N: 013652 Test time: NOT Open time in sec: Number of thermisters: TESTED Holding psi: NOT Specific gravity: Resiliency cc: TESTED Water table depth in inches: Test leak rate ml/m: 189.0 Determined by(method): Metering psi: Leak rate in gph: Calib. leak in gph: 3.00 Result: Results: PASS COMMENTS COMMENTS ULLAGE TEST RESULTSTeSt Met od: LINE TEST RESULTS Test type.ILj N Test time: Material: Dw FIBERG Ullage volume: Diameter(in): 2.0 Ullage pressure: Length(ft): 225.0 Results: Test psi: Bleedback cc: DATA FOR UTS-4T ONLY: Test time(min): Test 1:Start time: Time of test 1: Finish psi: NOT NOT NOT NOT Temperature: NOT Vol change cc: TESTED TESTED TESTED TESTED Test 2:Start time: Flow rate(cfh): TESTED Finish psi: Time of test 2: Vol change cc: Test 3:Start time: Temperature: Finish psi: Flow rate(cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate(cfh): Pump type: PRESSURE COMMENTS Pump make: FE PETRO COMMENTS Impact Valves Operational: YES IL Printed 11/21 12008 08:22 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS .p,Tankw1ogy TEST DATE: 11/17/08 '8501 N MOPAC EXPRESSWAY,SUITE 400 WORK ORDER NUMBER: 3163334 AUSTIN,TEXAS 78759(512)451-6334 CLIENT: CHEVRON PRODUCTS SITE: CHEVRON 203576 TANKiI_M�ORMATION Tank ID: 12k 3 Tank manifolded: No Bottom to top fill in inches: 165.0 Product: REGULAR Vent manifolded: YES Bottom to grade in inches: 170.0 Capacity in gallons: 12,068 Vapor recovery manifolded: YES Fill pipe length in inches: 54.0 Diameter in inches: 111.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: ASSIST CP installed on: COMMENTS TANK TEST RE LILTS Test etho L D TOR _ ST R LILTS Tes method PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D.#1 L.D.#1 L.D.#2 L.D.#2 LIFT/OFT: Make: VEEDERROOT Fluid volume in gallons: Model: ELECTRONIC Tank water level in inches: S/N: 013649 Test time: NOT Open time in sec: Number of thermisters: TESTED Holding psi: NOT Specific gravity: Resiliency cc: TESTED Water table depth in inches: Test leak rate ml/m: 189.0 Determined by(method): Metering psi: Leak rate in gph: Calib. leak in gph: 3.00 Result: Results: PASS COMMENTS COMMENTS ULLAGE l jJlNEJTE ST RESULTS r st type IIN sin Test time: Material: Dw FIBERG Ullage volume: Diameter(in): 2.0 Ullage pressure: Length (ft): 225.0 Results: Test psi: Bleedback cc: DATA FOR UTS-4T ONLY: Test time (min): Test 1:Start time: Time of test 1: Finish psi: NOT NOT NOT NOT Temperature: NOT Vol change cc: Test 2:Start time: TESTED TESTED TESTED TESTED Flow rate(Cfh): TESTED Finish psi: Time of test 2: Vol change cc: Test 3:Start time: Temperature: Finish psi: Flow rate(cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate(cfh): Pump type: PRESSURE COMMENTS Pump make: FE PETRO COMMENTS Impact Valves Operational: YES Printed 11/21/2008 08:22 ACRAMER